A Controlled Study of Trimethoprim-Sulfamethoxazole Prophylaxis of Urinary Tract Infection in Renal Transplant Recipients

Ne, Tolkoff-Rubin; Ab, Cosimi; Ps, Russell; Rh, Rubin

doi:10.1093/clinids/4.2.614

Cited by 117 publications

(49 citation statements)

References 20 publications

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“…This intervention is predicated on the finding in at least one study that early UTI may be associated with diminished allograft function, at least transiently, and that trimethoprim-sulfamethoxazole prophylaxis reduces the risk for UTI threefold, without resulting in significant colonization by trimethoprim-sulfamethoxazole-resistant gram-negative bacilli (77,78). Whether patients who are unable to receive trimethoprim-sulfamethoxazole should be given alternative prophylaxis is not known, but that option could be considered (5).…”

Section: Urinary Tract Infectionmentioning

confidence: 99%

Common Infections in Kidney Transplant Recipients

Karuthu¹,

Blumberg

2012

Clinical Journal of the American Society of Nephrology

210

148

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SummaryInfections are a major cause of morbidity and mortality in kidney transplant recipients. To some extent, these may be preventable. Careful pretransplant screening, immunization, and post-transplant prophylactic antimicrobials may all reduce the risk for post-transplant infection. However, because transplant recipients may not manifest typical signs and symptoms of infection, diagnoses may be confounded. Furthermore, treatment regimens may be complicated by drug interactions and the need to maintain immunosuppression to avoid allograft rejection. This article reviews common post-transplant infections, including prophylactic, diagnostic, and treatment strategies, providing guidance regarding care of kidney transplant patients with infection.

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Section: Urinary Tract Infectionmentioning

confidence: 99%

Common Infections in Kidney Transplant Recipients

Karuthu¹,

Blumberg

2012

Clinical Journal of the American Society of Nephrology

210

148

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“…(44,45). (21,49 (49,50), and led to recommendations for use of prophylactic antibiotics (TMP-SMX) for 6 months-1 year posttransplant (45). As uropathogenic bacteria have become more TMP-SMX resistant (40,41) …”

Section: Risk Factorsmentioning

confidence: 99%

Urinary Tract Infections in Solid Organ Transplant Recipients

Rice

Safdar

2009

American Journal of Transplantation

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Epidemiology Urinary tract infection (UTI) is the most common infection in the renal Enterobacter and other organisms (group B streptococci, and Gardnerella vaginalis) also occurring (Figure 1) (4,(10)(11)(12)(13)(14) UTI and pyelonephritis (24,25). Vesico-ureteral reflux (VUR) majority of pyelonephritis isolates from immunosuppressed patients (17,18). In addition, a subset of O antigen serotypes are present on the majority (80%) of E. coli isolates from patients with UTI (11,19). Although most studies document a decreased prevalence of virulence factors expressed by uropathogenic E. coli from compromised hosts, likely reflecting the weaker barriers to infection in this population (17), a recent report suggests that unique patterns of uropathogenic of O:H serotypes and P fimbriae adherence factor among E. coli isolates from renal transplant patients with UTI (20). Risk factors

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“…Trimethoprim/sulfamethoxazole (TMP/SMX), traditionally used for prophylaxis against Pneumocystis jiroveci pneumonia, has proven efficacy in reducing the incidence of UTIs, as well as bacteremias after transplantation [36,37], although resisitance to common urinary tract pathogens is increasingly common in more recent years [16,38]. TMP/SMX is also effective in preventing infections by L monocytogenes, Nocardia species, and Toxoplasmosis gondii, leading to recommendations for its use in all patients without contraindication to its use [2].…”

Section: Prophylaxis Of Bacterial Infectionmentioning

confidence: 99%